AB1404 THE ASSOCIATION OF PAIN INTENSITY AND MUSCULOSKELETAL FACTORS, PHYSICAL ACTIVITY, AND QUALITY OF LIFE IN PREGNANT WOMEN WITH LOW BACK PAIN: A CROSS-SECTIONAL STUDY
Authors: E. Üzelpasaci, T. Akbayrak
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Low back pain (LBP) is one of the most common musculoskeletal problems affecting pregnant women. While the etiology/pathogenesis of pregnancy-related LBP (PR-LBP) has not been fully explained, it is thought to stem from several biological/physical factors including hormonal, vascular, and biomechanical changes, trauma, metabolic factors, insufficient muscle control, stress, weight gain, sedentary lifestyle, muscle function loss [1,2]. As such, risk factors need to be assessed comprehensively during pregnancy and those women who are at risk should be given preventive recommendations. <h3>Objectives</h3> The aim of this study was to determine the association between musculoskeletal factors (abdominal muscle thickness and diastasis recti), physical activity, quality of life and self-reported LBP intensity during different trimesters of pregnancy. <h3>Methods</h3> A total of 107 pregnant women who were between 11 and 37 weeks of gestation, without obstetric and medical complications were included in this study. Detailed, sociodemographic and obstetric characteristics were recorded. The pregnant women were shown the region of LBP on a figure and they were asked to mark the relevant average pain intensity on a 10 cm Visual Analogue Scale (VAS). Disability was evaluated using the Oswestry Disability Index (ODI) to evaluate the degree of loss of functionality. Abdominal muscle thicknesses and diastasis recti were measured by ultrasonography. Pregnancy Physical Activity Questionnaire (PPAQ) and Short Form-36 (SF-36) were used to assess physical activity and quality of life. Univariate regression was used to analyse associations between each plausible independent variable and low back pain severity. <h3>Results</h3> Among 107 primiparous women, 43 were in the 1<sup>st</sup> trimester (mean age: 31.18±4.58 years, mean body mass index (BMI): 24.15±4.26 kg/m<sup>2</sup>), 33 in the 2<sup>nd</sup> trimester (mean age: 30.62±4.53 years, BMI: 25.65±3.77 kg/m<sup>2</sup>), and 32 were in the 3<sup>rd</sup> trimester (mean age: 30.58±4.60 years, BMI: 27.08±3.70 kg/m<sup>2</sup>). The mean LBP intensity was 3.09±2.37 and they were 2.68±2.09, 2.73 ±1.98, 2.16± 2.01 for the 1<sup>st</sup>, 2<sup>nd</sup> and 3<sup>rd</sup> trimesters, respectively. Demographic and medical variables in pre-pregnancy and pregnancy periods were not associated with PR-LBP intensity. On the contrary, ODI score was associated with LBP intensity during pregnancy. Higher ODI score shows severe low back pain (coef=0.05, R2=0.11, p=0.03) and ODI scores explain 11%, 13% and 26% of LBP severity during 1<sup>st</sup>, 2<sup>nd</sup> and 3<sup>rd</sup> trimester, respectively. Musculoskeletal variables (abdominal muscle thickness and diastasis recti) were not associated with PR-LBP intensity. SF-36 emotional role limitation (coef=-0.03, R2=0.20, p=0.01) in the 3<sup>rd</sup> trimester and SF-36 pain in the 1<sup>st</sup> (coef=-0.04, R2=0.12, p=0.02) and 3<sup>rd</sup> (coef=-0.05, R2=0.26, p=0.004) trimesters were associated with PR-LBP intensity. Rest of the SF-36 subscales were not associated with LBP intensity during any trimester. Physical activity were not associated with PR-LBP intensity, except of the PPAQ-sedentary during the 2<sup>nd</sup> trimester (coef=0.17, R2=0.17, p=0.02). <h3>Conclusion</h3> Increased PR-LBP intensity can be associated with different factors in different trimesters of pregnancy. Clinicians should comprehensively assess pregnant women, taking into account the relevant risk factors according to trimester, and make preventive/therapeutic recommendations for pregnant women. <h3>References</h3> [1]Berber MA, Satilmiş İG. Characteristics of Low Back Pain in Pregnancy, Risk Factors, and Its Effects on Quality of Life. Pain Management Nursing. 2020;21(6):579-86. [2]Chang HY, Lai YH, Jensen MP, Shun SC, Hsiao FH, Lee CN, et al. Factors associated with low back pain changes during the third trimester of pregnancy. Journal of advanced nursing. 2014;70(5):1054-64 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.